Initiation of evidence-based psychotherapies in Veterans with posttraumatic stress disorder

The Department of Veterans Affairs (VA) requires that all VA hospitals and clinics provide access to evidence-based psychotherapies (EBPs). Despite these widespread dissemination efforts, only a minority of Veterans receive EBP services. Reasons for these low rates of EBP utilization are largely unknown. This study examined the characteristics of Veterans with posttraumatic stress disorder (PTSD) who did (Initiation group) and did not (No-Initiation group) initiate a VA-approved EBP after participating in an information session. Veterans chose their preferred treatment from a menu of EBPs. Results demonstrated that Veterans in the No-Initiation group had longer periods of time between their referral and first EBP visit. Among Veterans in the Initiation group, the majority (68%) initiated a trauma-focused EBP as their first or second treatment, suggesting that providing a range of treatment options did not negatively impact their willingness to engage in PTSD treatment. Results are discussed in terms of VA initiatives to improve access to and initiation of mental health care for Veterans.     

Attitudes Toward Adoption of Evidence-Based Practices: A comparison of Autism Early Intervention Providers and Children's Mental Health Providers

Across the country, states are reporting increases in the number of children with autistic spectrum disorders (ASD) served each year in the early intervention system. Research examining factors impacting the successful dissemination and implementation of evidence-based practice (EBPs) into service systems for these children is limited. Preliminary information indicates that adoption of EBPs is variable. Provider attitudes toward the adoption of EBPs may be one factor that limits or facilitates implementation of efficacious treatments and these attitudes vary by organizational context and provider individual differences. The current study examines cross-context differences in provider attitudes toward EBPs by comparing the attitudes of 71 education-based early intervention providers working with children with ASD to the attitudes of 238 mental health providers in the public mental health system. This provides the first examination of ASD early intervention provider attitudes toward EBP. Results indicated that early intervention providers reported significantly more favorable attitudes toward adopting EBPs than did mental health providers. Early intervention providers with extended experience in the field perceived less divergence between their current practice and EBPs. Implications are discussed.     

Virtually Jewish

SUMMARY

The authors created a Web-based tutorial for novice-to-intermediate users of the World Wide Web using primarily Jewish content in order to encourage potential Jewish users of the World Wide Web. The lessons contain information on Jewish-themed Web sites and progressively complex information about how to use the Web. Tips and practice exercises are included.     

The Role of Professional Training Experiences and Manualized Programs in ABA Providers’ Use of Parent Training With Children With Autism

Parent training, in which providers teach parents intervention strategies to promote their children’s skill acquisition and/or behavior management, is considered a best practice in the treatment for children with autism spectrum disorder (ASD) and yet is underutilized in community settings. The present study examined the role of training experiences and manual use in promoting the use of parent training by community providers who serve children with ASD. Applied behavior analysis (ABA) providers (N = 1,089) from across the United States completed self-report questionnaires online. The total number of professional training experiences related to parent training significantly predicted the extensiveness of providers’ use of parent training. Receiving supervision in parent training, being trained in a specific parent training approach, taking a course related to parent training, and participating in self-guided learning (e.g., webinar) were unique predictors of parent training extensiveness. While only 15% of ABA providers used manualized parent training programs, using a manual was also a unique predictor of parent training extensiveness. Parallel multiple mediator analyses demonstrated that family-, provider-, and organization-level barriers all partially mediated the relationship between number of training experiences and parent training extensiveness; only provider- and organization-level barriers mediated the relationship between manual use and parent training extensiveness. Recommendations for training and supporting providers at the pre-service and in-service levels are discussed as a means of increasing access to parent training for children with ASD in community settings.     

Tools for remote usability evaluation of Web applications through browser logs and task models

The dissemination of Web applications is extensive and still growing. The great penetration of Web sites raises a number of challenges for usability evaluators. Video-based analysis can be rather expensive and may provide limited results. In this article, we discuss what information can be provided by automatic tools able to process the information contained in browser logs and task models. To this end, we present a tool that can be used to compare log files of user behavior with the task model representing the actual Web site design, in order to identify where users’ interactions deviate from those envisioned by the system design.     

Associations of Health-Related Quality of Life with Healthcare Utilization Status in Veterans

Evidence indicates that veterans using VA healthcare services have poor health-related quality of life (HRQOL). Little is known, however, about differences in HRQOL among those who only use VA services and those who also use non-VA services. We sought to evaluate differences in HRQOL among veterans who use: (1) only non-VA services (2) only VA services and (3) both VA and non-VA services (i.e., dual users). A cross-sectional study of 39,942 US veterans who completed the CDC’s 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was analyzed. Self-rated measures of global health status and the number of days per month that veterans were limited by physical or mental problems were extracted from BRFSS survey data as outcomes. Multivariate logistic regression demonstrated that, compared to those receiving all healthcare outside of VA, veterans receiving VA care were more likely to report poorer health outcomes, including worse global health status, greater impairments in physical functioning, and increased limitations regarding routine activities (p’s ≤ .05). Both exclusive and dual users of VA services reported poorer HRQOL than individuals not using VA services. More research is needed regarding veterans’ health status, particularly in the context of dual use.     

Web-based strategies to disseminate a sun safety curriculum to public elementary schools and state-licensed child-care facilities.

The Sunny Days, Healthy Ways curriculum, which has been effective in previous trials, was disseminated to public elementary schools (n=2,030) and state-licensed child-care facilities (n=3,755) in 4 states. Two Web sites were created, varying in the amount and type of information. Mailings referred principals and directors to the sites. Overall 117 unique users made 172 visits to the sites. More repeat visits were made to the enhanced than to the basic site (p=.04). In a survey, 20.0% of principals and directors recalled receiving the mailings and 80.9% of these read them. Web-based strategies were weak, but the low response rate may be typical for such marketing. They will require supplementation by more personal approaches.     

Effects of workshop trainings on evidence-based practice knowledge and attitudes among youth community mental health providers

Enhancing the public health impact of evidence-based practices (EBPs) in usual care settings is a key priority of the National Institute of Mental Health. Longitudinal data from community mental health providers (N = 268) participating in a series of state-sponsored workshops in modular approaches to EBPs for youth are presented. EBP workshop attendance for youth anxiety resulted in increased knowledge for EBPs for anxiety (and not other conditions) and EBP workshop attendance for youth disruptive behaviors resulted in increased knowledge for EBPs for disruptive behaviors (and not other conditions). Providers' tendencies toward incorrectly classifying non-EBP therapies as evidence-based increased over time, suggesting that providers over-generalize the EBP label as a result of attending these types of workshops. Regarding EBP attitudes, most measures of attitudes improved when providers attended a workshop. Additionally, an overly inclusive view of what constitutes an EBP at intake was related to significant decreases in openness to trying EBPs over time, whereas more positive attitudes at intake was related to achieving a more refined view of what constitutes an EBP over the course of attending trainings. Study limitations and implications for implementation of EBPs in usual care settings are discussed.     

A multimethod approach to examining usability of Web privacy polices and user agents for specifying privacy preferences

Because all research methods have strengths and weaknesses, a multimethod approach often provides the best way to understand human behavior in applied settings. We describe how a multimethod approach was employed in a series of studies designed to examine usability issues associated with two aspects of online privacy: comprehension of privacy policies and configuration of privacy preferences for an online user agent. Archival research, user surveys, data mining, quantitative observations, and controlled experiments each yielded unique findings that, together, contributed to increased understanding of online-privacy issues for users. These findings were used to evaluate the accessibility of Web privacy policies to computer-literate users, determine whether people can configure user agents to achieve specific privacy goals, and discover ways in which the usability of those agents can be improved.     

The cyber-aspects of virtual communities: free downloader ethics, cognition, and perceived service quality.

This study examined the downloader cognitive structures toward Web service quality and the downloader ethical attitudes across various levels of participation in a virtual community. Using four types of free downloads as the research subjects, the researcher found that the users in different participation degrees have different perception preferences. Owners of the free downloading Web sites can use the findings of this study to develop effective Web marketing strategies.     

Resources relevant to the creation of a psychology department home page

Home page construction can give even the smallest academic department world access, in terms of both the sharing of information and the reception of data from Internet users as well as other academic departments. The World-Wide Web (WWW) allows for rapid dissemination of information and data pertinent to the science of psychology, as well as the exchange of information relevant to clinical and experimental psychology. This paper will explore and analyze resources relevant to the creation of a psychology department home page on the WWW.     

Development and evaluation of the evidence‐based practice classroom observation measure (EBP‐COM)

Due to the increased emphasis on evidence‐based practices (EBPs) in recent education initiatives, classroom observers need an objective way to measure teacher use of EBPs. Although some measures for this purpose exist, these measures are limited by their reliance on self‐report. Therefore, we created a direct observation tool titled the Evidence‐Based Practice Classroom Observation Measure (EBP‐COM) for observers to assess the use of EBPs by teachers of students with autism spectrum disorder (ASD). We evaluated reliability and validity of the EBP‐COM, as well as whether the assessment tool could detect change in teacher behavior. A measurement refinement process involving six raters collecting 65 data points revealed the EPB‐COM to have sound psychometric properties. With this tool, researchers can conduct comprehensive and objective assessments of teacher EBP use.     

Rational analyses of information foraging on the web

This article describes rational analyses and cognitive models of Web users developed within information foraging theory. This is done by following the rational analysis methodology of (a) characterizing the problems posed by the environment, (b) developing rational analyses of behavioral solutions to those problems, and (c) developing cognitive models that approach the realization of those solutions. Navigation choice is modeled as a random utility model that uses spreading activation mechanisms that link proximal cues (information scent) that occur in Web browsers to internal user goals. Web-site leaving is modeled as an ongoing assessment by the Web user of the expected benefits of continuing at a Web site as opposed to going elsewhere. These cost–benefit assessments are also based on spreading activation models of information scent. Evaluations include a computational model of Web user behavior called Scent-Based Navigation and Information Foraging in the ACT Architecture, and the Law of Surfing, which characterizes the empirical distribution of the length of paths of visitors at a Web site.     

Más Allá De Las Barreras: Competency and Practice Considerations in Language,Cultural, and Social Issues When Delivering Group CPT to Hispanic Immigrants

ABSTRACT

High rates of underassessed trauma and psychiatric disorders, particularly post-traumatic stress disorder (PTSD) have been reported among Hispanic immigrants, especially as related to immigration trauma. Multiple studies have shown group cognitive processing therapy (CPT) to be an effective evidence-based practice (EBP) for treatment of PTSD across a number of clinical populations. To date, however, no studies have examined important competency and practice issues in linguistic, cultural, and ethical areas that group CPT providers should consider when delivering group CPT to Hispanic immigrants. This article aims to outline these and provide future directions for research.     

Observer Perceptions of Would-Be Provider and Would-Be Recipient Reactions to Rejected Social Support1

Role-playing observers predicted the reactions of hypothetical would-be recipients whose requests for social support were unmet as well as those of hypothetical would-be providers for their rejection of such requests. The extent to which the would-be recipient was depicted at fault for the problem was predicted to affect perceived reactions since support may be less likely when potential recipients are blameworthy than when they are innocent of responsibility for their predicament. Observers perceived would-be recipients of support as believing that would-be providers blamed them. Observers saw would-be providers as blaming the would-be recipients rather than themselves, especially if the victim was blameworthy. When the victim was not blameworthy, would-be providers were more likely than would-be recipients to be judged to use a mixture of rationalizations and excuses rather than blame.     

Examining Information Processing on the World Wide Web Using Think Aloud Protocols

Some theorists argue that the node-link design of the Web mimics human information storage and that Web use encourages individuals to process information efficiently and effectively, potentially increasing meaningful learning. However, critics claim that Web navigation increases cognitive load and often produces disorientation. This reduces the processing devoted to meaningful learning, and, thus the Web may potentially inhibit learning. In an examination of information processing on the Web using a quantitative analysis of think aloud protocols, we found that users spend a substantial proportion of their cognitive effort orienting to the content and structure of the Web, and this effort comes at the expense of elaborative and evaluative processing. Additional findings suggest that, at least during a single relatively short session, time spent in a given site does not reduce the processing devoted to orientation. Finally, this paper offers a theoretically informed strategy for analyzing information processing activities that may be of use to other scholars.     

Tools for Assessing Readability and Quality of Health-Related Web Sites

With the Internet becoming a growing source of information on genetics, genetic counselors and other health-care providers may be called upon to guide their patients to appropriate material, which is written at a suitable reading level for the individual and contains quality information. Given that many health-related Web sites are written at a high school or higher reading level, without direction from a genetic counselor or health-care provider, many Internet users may currently be turning to health-related Web sites that they do not understand. Additionally, Internet users may not know how to evaluate the quality of information they find, which could lead to them access inaccurate or irrelevant information. To aid in the process of finding and designing Web sites that are appropriate for patients, the current article provides guidelines for assessing readability and quality of health-related content. Additionally, a demonstration of an assessment is provided. Finally, limitations of these assessments are discussed.     

A Review of “Handbook for the Study of the Historical Jesus”

SUMMARY

The library Web site is a significant access point to a library's collections, resources, and services. A Web site can and should provide information about the library in a way that can be efficiently navigated and used by all library patrons. The usability of a library Web site can be improved through changes in organization and design informed by the experiences of real users. User expectations should be primary in determining the content, purpose, organization, and design of the site.